Basic Information
| Provider Information | |||||||||
| NPI: | 1235438037 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERSAD | ||||||||
| FirstName: | MALINI | ||||||||
| MiddleName: | DEVI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D./M.P.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES | ||||||||
| Address2: | 19 BRADHURST AVENUE, SUITE 3100N | ||||||||
| City: | HAWTHORNE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149099018 | ||||||||
| FaxNumber: | 9149099028 | ||||||||
| Practice Location | |||||||||
| Address1: | WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES | ||||||||
| Address2: | 19 BRADHURST AVENUE, SUITE 3750S | ||||||||
| City: | HAWTHORNE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149099018 | ||||||||
| FaxNumber: | 9149099028 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2011 | ||||||||
| LastUpdateDate: | 11/22/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD468393 | PA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VM0101X | MD468393 | PA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine | 207VM0101X | 278397 | NY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1036911940001 | 05 | PA | MEDICAID |